Using cone-beam CT as a low-dose 3D imaging technique for the extremities: initial experience in 50 subjects
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To prospectively evaluate a dedicated extremity cone-beam CT (CBCT) scanner in cases with and without orthopedic hardware by (1) comparing its imaging duration and image quality to those of radiography and multidetector CT (MDCT) and (2) comparing its radiation dose to that of MDCT.
Materials and methods
Written informed consent was obtained for all subjects for this IRB-approved, HIPAA-compliant study. Fifty subjects with (1) fracture of small bones, (2) suspected intraarticular fracture, (3) fracture at the site of complex anatomy, or (4) a surgical site difficult to assess with radiography alone were recruited and scanned on an extremity CBCT scanner prior to FDA approval. Same-day radiographs were performed in all subjects. Some subjects also underwent MDCT within 1 month of CBCT. Imaging duration and image quality were compared between CBCT and radiographs. Imaging duration, effective radiation dose, and image quality were compared between CBCT and MDCT.
Fifty-one CBCT scans were performed in 50 subjects. Average imaging duration was shorter for CBCT than radiographs (4.5 min vs. 6.6 min, P = 0.001, n = 51) and MDCT (7.6 min vs. 10.9 min, P = 0.01, n = 7). Average estimated effective radiation dose was less for CBCT than MDCT (0.04 mSv vs. 0.13 mSv, P = 0.02, n = 7). CBCT images yielded more diagnostic information than radiographs in 23/51 cases and more diagnostic information than MDCT in 1/7 cases, although radiographs were superior for detecting hardware complications.
CBCT performs high-resolution imaging of the extremities using less imaging time than radiographs and MDCT and lower radiation dose than MDCT.
KeywordsComputed tomography Cone-beam computed tomography Radiation dose Fracture Hardware Artifact
The authors would like to thank Marie Verlicco and Patricia Giorgio, registered radiologic technologists, for undergoing training in the operation of the Verity CBCT scanner and for recruiting subjects for the study.
Conflict of interest
The authors declare that they have no conflict of interest.
- 18.Hirschmann A, Pfirrmann CWA, Klammer G, Espinosa N, Buck FM. Upright Cone CT of the hindfoot: Comparison of the non-weight-bearing with the upright weight-bearing position. Eur Radiol. 2013.Google Scholar
- 29.United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation, Vol. 1: Sources, vol. 1. New York: United Nations Publishing; 2000.Google Scholar
- 48.American Association of Physicists in Medicine. Report of AAPM Task Group 111: The Future of CT Dosimetry. Comprehensive Methodology for the Evaluation of Radiation Dose in X-Ray Computed Tomography. AAPM; 2010.Google Scholar